Dyna-CT三维成像下卵圆孔形态学特征对经皮穿刺球囊压迫术的影响  

Influence of morphological features of oval foramen in Dyna-CT three-dimensional imaging in percutaneous balloon compressi

作　　者：吕旌 赵鹏[1] 胡鑫 覃春荣 何睿林[1] 蒋宗滨[1] Lyu Jing;Zhao Peng;Hu Xin;Qin Chunrong;He Ruilin;Jiang Zongbin(Department of Pain,Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]广西医科大学第二附属医院疼痛科,南宁530007

出　　处：《中华神经医学杂志》2022年第7期671-676,共6页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金培育基金(GJPY2018002);广西科技重点研发计划项目(桂科AB21220047);广西壮族自治区卫生健康委员会自筹科研课题(Z20200369);广西医科大学第二附属医院院级科研项目(EFYKY2020002);。

摘　　要：目的探讨原发性三叉神经痛(ITN)患者颅底卵圆孔形态学特征对经皮穿刺球囊压迫术(PBC)穿刺难度、疗效及术后并发症的影响。方法选择广西医科大学第二附属医院疼痛科自2020年1月至2021年1月收治的ITN患者127例,均采用血管造影三维软组织成像技术(Dyna-CT)下PBC治疗,术中测量卵圆孔形态学数据,手术前后采用数字疼痛评分(NRS)评估患者的疼痛程度。比较不同形态卵圆孔的横截面积和暴露角度、穿刺难度和时间、患者手术前后NRS评分及并发症发生率的差异;相关性分析卵圆孔的穿刺时间和穿刺难度、横截面积的相关性。结果127例患者颅底卵圆孔的形态分为标准卵圆形(82例)、杏仁形(9例)、狭长形(13例)、裂隙形(8例)、不规则形(15例)。不同形态卵圆孔的横截面积、暴露角度及穿刺难度、时间的差异均有统计学意义(P<0.05)。相关性分析结果显示,卵圆孔的穿刺时间和穿刺难度呈正相关关系(r=0.359,P<0.001),卵圆孔的穿刺时间和横截面积呈正相关关系(r=0.280,P=0.007)。不同形态卵圆孔患者手术前后NRS评分、并发症发生率的差异均无统计学意义(P>0.05)。结论Dyna-CT三维成像可直观显示颅底卵圆孔形态学特征,使用该技术可指导卵圆孔穿刺,评估PBC术的穿刺难度,但对患者术后疼痛程度、并发症的发生无影响。Objective To investigate the influences of morphological characteristics of skull base ovale foramen in the puncture difficulty of percutaneous balloon compression(PBC),surgical efficacy and postoperative complications in patients with idiopathic trigeminal neuralgia(ITN).Methods One hundred and twenty-seven patients with ITN,admitted to our hospital from January 2020 to January 2021,were collected.Dyna-CT three-dimensional imaging of the oval foramen at the skull base and PBC treatment were performed on the included patients,and the morphological data of the oval foramen were measured.Numeric Rating Scale(NRS)was used to assess pain degrees before and after surgery.The differences of cross-sectional area and exposure Angle,puncture difficulty and time,NRS scores before and after surgery and incidence of complications were compared in patients with ovale foramen at different forms.The correlations of puncture time with puncture difficulty and cross-sectional area of ovale foramen in skull base were analyzed.Results The foramen ovale in skull base of 127 patients included standard oval shape(n=82),almond shape(n=9),narrow and long shape(n=13),fissure shape(n=8)and irregular shape(n=15).Different morphological characteristics of the skull base ovale foramen could lead to significant differences in the difficulty of puncture,exposure angle,cross-sectional area and puncture time(P<0.05).Puncture time was positively correlated with puncture difficulty and cross-sectional area(r=0.359,P<0.001;r=0.280,P=0.007).The patients with skull base ovale foramen of different forms showed no significant differences in the differences of NRS scores before and after PBC and occurrence of postoperative complications(P>0.05).Conclusion Dyna-CT three-dimensional imaging can visually display the morphological characteristics of the oval foramen at the skull base;this technique can be used to guide the puncture of the oval foramen and effectively evaluate the difficulty of puncture in PBC,but it does not affect the postoperative pain imp

关 键 词：颅底卵圆孔 形态学特征 Dyna-CT三维成像 经皮穿刺球囊压迫术 三叉神经痛 

分 类 号：R651.3[医药卫生—外科学]